US Army Graduate Program in Anesthesia, Fort Sam Houston, San Antonio, Texas 78240, USA.
J Surg Res. 2010 Nov;164(1):126-30. doi: 10.1016/j.jss.2009.07.038. Epub 2009 Aug 26.
Hypothermia is a common battlefield trauma occurrence. This study compared the effectiveness of the hypothermia, environmental, exposure, and trauma (HEET) garment (Trident Industries, Beaufort, SC) with and without thermal inserts with a control group of two wool blankets in the prevention of hypothermia in a treated hypovolemic porcine model.
Five female swine (Sus scrofa-Yorkshire cross) were assigned to each of three groups: HEET with thermal inserts (n=5); HEET without thermal inserts (n=5); or control (n=5). After the animals were anesthetized and stabilized for 30 min, the swine were hemorrhaged to a mean arterial pressure (MAP) of 30 mm Hg, simulating a battlefield injury. Hetastarch 6% (500 mL) was rapidly administered, simulating initial field resuscitation. One hour later, the animals' shed blood was reinfused, simulating transfusion at a field medical facility. The investigators moved the animal into a cooler set at 10°C ± 0.5°C. A pulmonary artery catheter was used to monitor core body temperature over a 6-h period.
A repeated measures ANOVA and Tukey's post hoc test were used to analyze the data. There was a significant difference between the groups. At the end of 6h, the mean core temperature for the HEET with inserts group was 32.69°C ± 1.5; the HEET without inserts, 31.02°C ± 1.8; and control, 34.78°C ± 1.2 (P<0.05). While all groups became hypothermic, the wool blanket group was most effective in maintaining body temperature closer to normothermia.
The HEET garments with and without heaters are ineffective in preventing hypothermia.
低体温是战场上常见的创伤发生情况。本研究比较了 Hypothermia, Environmental, Exposure, and Trauma (HEET) 服装(Trident Industries,Beaufort,SC)带和不带热垫与对照组的两条羊毛毯在治疗性低血容量猪模型中预防低体温的效果。
将 5 只雌性猪(Sus scrofa-Yorkshire 杂交)分配到三组:带热垫的 HEET(n=5);不带热垫的 HEET(n=5);或对照组(n=5)。在动物麻醉和稳定 30 分钟后,将猪出血至平均动脉压(MAP)为 30mmHg,模拟战场损伤。快速给予 6%羟乙基淀粉(500mL),模拟初始现场复苏。1 小时后,动物的失血被回输,模拟在现场医疗设施的输血。研究人员将动物转移到 10°C±0.5°C 的冷却器中。肺动脉导管用于监测核心体温 6 小时。
采用重复测量方差分析和 Tukey 的事后检验分析数据。组间存在显著差异。在 6 小时结束时,带插入物的 HEET 组的平均核心体温为 32.69°C±1.5;不带插入物的 HEET 组为 31.02°C±1.8;对照组为 34.78°C±1.2(P<0.05)。虽然所有组都出现低体温,但羊毛毯组在维持体温接近正常方面最有效。
带和不带加热器的 HEET 服装在预防低体温方面无效。